Agent  ______________

Attorney  __________________

Sex___ male ____ female _____ formerly male_______

formerly female __________ both ___________

If female, indicate breast implant size  ______

Will the size of your implants hinder your ability to safely
operate a motor vehicle in any way?  Yes___  No ___

Occupation
[  ]  Lawyer
[  ]  Actor/Waiter
[  ]  Filmmaker/Self-employed
[  ]  Porn Star
[  ]  Writer
[  ]  Car Dealer
[  ]  Agent
[  ]  Prostitute/Transvestite
[  ]  Other; please explain___________________

Please indicate how many times you expect to have sex in a car

Please indicate how much you plan to spend for this sex

Please list
Brand of cell phone  __________. (If you don't own a cell phone,
please explain.)

Please check hair color
Females[  ] Blonde [  ] Platinum  Blonde  [  ] Beach Bunny Blonde
Teenagers[  ] Purple [  ] Blue [  ] Skinhead
Men Please list shade of hair plugs.

Please check activities you perform while driving (check all that apply)
[  ] Eating a veggie wrap
[  ] Applying make-up
[  ] Talking on cell phone
[  ] Snorting cocaine
[  ] Slapping kids in the backseat
[  ] Having sex
[  ] Applying cellulite treatment to thighs
[  ] Tanning
[  ] Watching TV
[  ] Reading Variety

Please indicate how many times
a) you expect to shoot at other drivers, and
b) how many times you expect to be shot at while driving.

A simple test
If you are the victim of a car-jacking, you should immediately
a) Call the police to report the crime;
b) Call Channel 4 News to report the crime, then watch your car on the news on a high-speed chase;
c) Call your attorney and discuss lawsuit against cellular phone company for 911 call not going through;
d) Call your therapist;

Please indicate if you drive
a) a BMW,
b) a Lexus,
c) a Mercedes, or
d) Cabriolet.
If your answer is D, please add six to eight weeks to normal delivery time for your driver's license.

In the event of an earthquake, should you
a) stop your car,
b) keep driving and hope for the best,
c) immediately use your cell phone to call your agent and all loved ones, or
d) cry

In the instance of rain, you should
a) never drive over 5 MPH,
b) drive twice as fast as usual, or
c) what is this "rain" you speak of?

Please indicate number of therapy sessions per week  ____.

Are you presently taking any of the following medications?
a) Prozac
b) Zovirax
c) Lithium
d) Zanax
e) all of the above

If none, please explain  __________________.

Length of daily commute
a) 1 hour;
b) 2 hours;
c) 3 hours;
d) 4 hours or more.

When stopped by police, you should
a) pull over and have your driver's license and insurance form ready,
b) try to outrun them by driving in the opposite direction on the 405,
c) have your video camera ready and provoke an attack, insuring yourself of a hefty lawsuit

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